Perhaps you've already
taken the Quick Quiz. This survey goes deeper into the issues to help you
decide if Take-Charge Living is a useful program for you.

QUESTION
ONE: PERSONAL CONTROL

How well do you meet the challenge
of changing your behavior when you know it would improve the quality of your
life?

To help you answer that question,
look at the following scale. Picture number 1 as the rating of people who
feel quite helpless, almost totally out of control of their lives. Number
10 is the opposite, people who feel on top of things and quite in charge of
their lives. This scale is a useful first step for taking stock of your situation.

Take a moment. Think about it.
At this point in your life, where do you place yourself?

How Much I Feel
In Control Of My Life

1

2

3

4

5

6

7

8

9

10

I feel very little
personal control
over my life

I
feel a lot of
personal control
over my life.

Chances are the less
personal control you feel you have-that is, the less in charge you feel over
your life-the less happy you are.

QUESTION TWO: PERSONAL SATISFACTION:

Overall, are you reasonably satisfied with how you run your
life?

Yes____ No____

Are you satisfied with your attitudes toward people and situations?

Yes____ No____

Are you satisfied with the way you handle yourself personally?

Yes____ No____

Are you satisfied with the way you cope with problems?

Yes____ No____

If your answers are more
negative than positive, the guidelines in this book and CD can help you change.

QUESTION
THREE: MANAGING YOURSELF

Do you neglect or poorly
manage any of the following?

· Your health?
Yes______ No_______

· Your relationships? Yes______ No_______

· Your work or school? Yes______ No_______

· Your body? Yes______ No_______

· Your possessions? Yes______ No_______

· Your living space? Yes______ No_______

· Your finances? Yes______ No_______

· Your time? Yes______ No_______

· Other? ____________________

Do you abuse food, alcohol,
or drugs? Do you smoke? Do you engage in any other risky, detrimental, or
personally harmful behaviors?

Yes______ No_______

Do you lose out because
you procrastinate about things that are important to you?

Yes______ No_______

Do you avoid pursuing your life goals?

Yes______ No_______

Other problem areas? ____________________________________________

A yes answer to any of
these questions says you are not in good enough charge when it comes to taking
good care of yourself.

QUESTION FOUR: ARE YOU WILLING TO DO SOMETHING TO
CHANGE?

Yes______ No_______

You do not have to know
what that something is. You do not have to feel like changing. You just must
be willing to try. It's my job to show you the path and guide you as long
as you are willing to take that walk with me.

Take-charge living is
a gift that only you have the power to give to yourself. It takes some effort,
but not an overwhelming amount. The guidelines in Take-Charge Living: How
to Recast Your Role in Life In Six Acts offer you support and show you
step-by-step exactly what to do.

I can promise you that
making the effort to learn how to live a take-charge life is well worth the
payoff. Take-charge living is a gift you give yourself that keeps on giving.